REPUBLIC OF THE PHILIPPINES)

CITY OF CEBU )Sc.

AFFIDAVIT OF VERIFICATION

I, , Filipino, of legal age, married and with office address at,

under oath, hereby depose and state THAT:

1. I am the

2. I caused the

3. I have not commenced any other action or proceeding involving the same
issues in any other court, tribunal, or agency; if there is any such action or proceeding
which is either pending or may have been terminated, I oblige to state the status thereof;
that if I may thereafter learn that a similar action or proceeding has been filed or is
pending with any other court, tribunal or agency, I undertake to report that fact within
five (5) days therefrom to this Honorable Office

4. I have read the same and all the allegations therein are true and correct
and of my personal knowledge and/or based on authentic documents;

IN WITNESS WHEREOF, I have hereunto set my hand this __ day of

___________________2018 at Cebu City, Philippines.

___________________

BEFORE ME, a notary public in and for the city named above, personally
appeared affiant with his _______________ ID with I.D
No._____________________, who is personally known to me to be the same
person who presented the foregoing instrument and signed the instrument in my
presence, and who took an oath/affirmation before me as to such instrument.

Witness my hand and seal this __ day of ________________ 2018.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2018.